[Indications for nuclear medicine diagnosis in trauma surgery]

Skeletal scintigraphy is the most frequently utilized nuclear medicine imaging procedure in traumatology. Concerning any skeletal abnormality associated with changes in local perfusion, exudation and metabolism, it is a sensitive functional imaging procedure to detect bony disease. However, because of the varying causes of bony disease, it is characterized by a low specificity. Further, specificity may be enhanced, when patient history, clinical and lab results as well as results obtained from other diagnostic imaging procedures are combined with the result of skeletal scintigraphy. On the other hand, it is known that metabolic abnormalities of the skeleton depicted by radionuclide imaging occur much earlier than structural changes visible on X-ray imaging. Beside skeletal scintigraphy, antigranulocyte antibody or labelled leucocyte imaging may greatly assist in the detection of inflammation or infection following joint replacement surgery, respectively. Ultimatively, a combination of clinical, lab and imaging results including radionuclide imaging may represent the best approach to answer some questions asked by surgical traumatologists.